ABSTRACT
These neurohumoral changes lead to increased splanchnic hyperemia and a hyperdynamic systemic circulation with a low arterial blood pressure and increased cardiac output.
clinical manifestations Variceal Bleeding Variceal bleeding is one of the major complications of portal hypertension requiring medical and surgical therapies ( 14 ). Screening endoscopy in cirrhotics shows that patients with more advanced liver disease and a lower platelet count are more likely to have varices ( 15 ). Epidemiologic studies have shown linear progression of varices over time ( 16 ). All patients with cirrhosis should undergo an initial screening upper endoscopy for varices: if none are present this should be repeated every 2 years. If present, intervention with prophylactic therapy to prevent bleeding (primary prophylaxis) should be considered.
